不同渗透压造影剂对行冠状动脉介入术病人肾功能影响的Meta分析被引量：6

INFLUENCE OF CONTRAST AGENT WITH DIFFERENT OSTOMOTIC PRESSURE ON RENAL FUNCTION IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION:META-ANALYSIS

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摘要目的比较等渗与低渗造影剂对行冠状动脉介入术病人肾功能的影响。方法从Web of Science、Cochrane Library、PubMed、ScienceDirect、中国知网、万方、重庆维普、中国生物医学文献数据库中,检索关于等渗与低渗造影剂对行冠状动脉介入术病人肾功能影响的随机对照试验（RCT）,时间均从建库至2015年5月,纳入符合入选标准的文献进行Meta分析。结果最终纳入12篇RCT文献、3 850例病人。行冠状动脉介入术病人使用等渗和低渗造影剂者造影剂肾病（CIN）发生率差异无显著性（RR=0.90,95%CI=0.68～1.18,P〉0.05）;即使在慢性肾衰竭病人中使用等渗造影剂也不能有效减少CIN的发生（RR=0.99,95%CI=0.73～1.33,P〉0.05）。使用Iodixanol病人分别与使用Ioversol、Iopromide、Iopamidol病人比较,术后CIN的发生率差异无统计学意义（RR=0.62,95%CI=0.22～1.77,P〉0.05;RR=1.19,95%CI=0.90～1.56,P〉0.05;RR=1.19,95%CI=0.81～1.74,P〉0.05）;但使用Iodixanol与Iohexol病人术后CIN发生率比较差异有统计学意义（RR=0.20,95%CI=0.07～0.59,P〈0.01）。结论与低渗造影剂相比,等渗造影剂并不能有效降低CIN的发生率;但对于某些种类的低渗造影剂,等渗造影剂可能有一定的相对安全性。 Objective To compare the impact of IOCM and LOCM on renal function in patients undergoing PCI. Methods Published papers concerning the impact of IOCM and LOCM on renal function in patients undergoing PCI were searched from data base of Web of Science,Cochrance Library,PubMed,ScienceDirect,Chinese Text（CNKI）, WanFang DATA,Chongqing VIP,and SinoMed.The retrieval time was from the establishment of the base to May 2015.The research papers that meet the inclusion criteria were enrolled for Meta-analysis. Results Twelve papers（3 850patients）were finally enrolled.The difference in the incidence of radiographic contrast nephropathy（RCN）between IOCM and LOCM was not significant（RR=0.90,95%CI=0.68-1.18,P〉0.05）,even if using IOCM in chronic renal failure patients could not effectively decrease the onset of RCN（RR=0.99,95%CI=0.73-1.33,P〉0.05）.A comparison between patients using Iodixanol and those using Ioversol,Iopromide or Iopamidol,the differences in postoperative incidence of RCN were not statistically significant（RR=0.62,95%CI=0.22-1.77,P〉0.05;RR=1.19,95%CI=0.90-1.56,P〉0.05;RR=1.19,95%CI=0.81-1.74,P〉0.05）,but the difference in application between Iodixanol and Iohexol was statistically significant（RR=0.20,95%CI=0.07-0.59,P〉0.01）. Conclusion Compared with LOCM,IOCM cannot effectively reduce the incidence of radiographic contrast nephropathy,but for some kinds of LOCM,IOCM may have relative safety.

作者齐玉军廉哲勋迟诚孙永晨高小群

机构地区青岛大学附属医院心内科

出处《青岛大学医学院学报》 CAS 2016年第4期411-414,共4页 Acta Academiae Medicinae Qingdao Universitatis

关键词造影剂渗透压肾病血管成形术经腔经皮冠状动脉 META分析 contrast media osmotic pressure nephrosis angioplasty transluminal percutaneous coronary Meta-analysis

分类号 R541.4 [医药卫生—心血管疾病]

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参考文献16

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